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      Patterns of distant metastases in patients with clear cell renal cell carcinoma––A population‐based analysis

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          Abstract

          We developed this study to describe the patterns of distant metastasis (DM) and explore the predictive and prognostic factors of DM in clear cell renal cell carcinoma (ccRCC) patients. We collected the eligible patients from the Surveillance, Epidemiology, and End Result (SEER) database from 2010 to 2015. Then, comparisons of baseline characteristics between patients in different metastatic patterns were made. In addition, proportional mortality ratios (PMRs) and proportion trends of different patterns were calculated. Afterward, survival outcomes were explored by Kaplan–Meier (KM) analyses. Finally, predictive and prognostic factors of DM were investigated. A total of 33,449 ccRCC patients were eventually identified, including 2931 patients with DM and 30,518 patients without DM. 8.76% of patients suffered DM at their initial diagnosis, 35.01% of them had multiple metastases. Generally, lung (6.19%) was the most common metastatic site in patients with DM, and brain (1.20%) was the least frequent metastatic organ. The proportion trends of different metastatic patterns tended to be stable between 2010 and 2015. Moreover, higher tumor grade, T stage, and N stage were identified as risk factors of DM. Finally, age at diagnosis, grade, T stage, N stage, the administration of surgery, the number of metastatic sties, marital status, and household income were found to be significantly associated with prognosis. Lung was the most common metastatic site in ccRCC patients. Different survival outcomes and prognostic factors were identified for different metastatic patterns. Hence, our study would have great value for clinical practice in the future.

          Abstract

          Lung was the most common metastatic site in ccRCC patients. Different survivals and prognostic factors were identified for different metastatic patterns. Hence, our study would have great value for clinical practice in the future.

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          Most cited references35

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          Cancer statistics, 2020

          Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2016) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2017) were collected by the National Center for Health Statistics. In 2020, 1,806,590 new cancer cases and 606,520 cancer deaths are projected to occur in the United States. The cancer death rate rose until 1991, then fell continuously through 2017, resulting in an overall decline of 29% that translates into an estimated 2.9 million fewer cancer deaths than would have occurred if peak rates had persisted. This progress is driven by long-term declines in death rates for the 4 leading cancers (lung, colorectal, breast, prostate); however, over the past decade (2008-2017), reductions slowed for female breast and colorectal cancers, and halted for prostate cancer. In contrast, declines accelerated for lung cancer, from 3% annually during 2008 through 2013 to 5% during 2013 through 2017 in men and from 2% to almost 4% in women, spurring the largest ever single-year drop in overall cancer mortality of 2.2% from 2016 to 2017. Yet lung cancer still caused more deaths in 2017 than breast, prostate, colorectal, and brain cancers combined. Recent mortality declines were also dramatic for melanoma of the skin in the wake of US Food and Drug Administration approval of new therapies for metastatic disease, escalating to 7% annually during 2013 through 2017 from 1% during 2006 through 2010 in men and women aged 50 to 64 years and from 2% to 3% in those aged 20 to 49 years; annual declines of 5% to 6% in individuals aged 65 years and older are particularly striking because rates in this age group were increasing prior to 2013. It is also notable that long-term rapid increases in liver cancer mortality have attenuated in women and stabilized in men. In summary, slowing momentum for some cancers amenable to early detection is juxtaposed with notable gains for other common cancers.
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            Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

            The Lancet, 385(9963), 117-171
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              European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update

              The European Association of Urology Renal Cell Carcinoma (RCC) Guideline Panel has prepared evidence-based guidelines and recommendations for the management of RCC.
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                Author and article information

                Contributors
                qf199408@163.com
                wzj196611@163.com
                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                28 November 2020
                January 2021
                : 10
                : 1 ( doiID: 10.1002/cam4.v10.1 )
                : 173-187
                Affiliations
                [ 1 ] Department of Urology The First Affiliated Hospital of Nanjing Medical University Nanjing China
                [ 2 ] Department of Urology Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine the Second Hospital of Nanjing Nanjing China
                [ 3 ] First Clinical Medical College of Nanjing Medical University Nanjing China
                [ 4 ] Department of Surgery The Fifth Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
                [ 5 ] Department of Urologic Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
                Author notes
                [*] [* ] Correspondence

                Zengjun Wang, Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.

                Email: wzj196611@ 123456163.com

                Feng Qi, Department of Urologic Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China.

                Email: qf199408@ 123456163.com

                Author information
                https://orcid.org/0000-0002-9358-1136
                https://orcid.org/0000-0003-1061-7058
                https://orcid.org/0000-0002-4425-0656
                Article
                CAM43596
                10.1002/cam4.3596
                7826458
                33247630
                fe949c96-eed1-4ea8-b908-1cbd18616b4c
                © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 August 2020
                : 18 October 2020
                : 19 October 2020
                Page count
                Figures: 6, Tables: 5, Pages: 15, Words: 16799
                Categories
                Original Research
                Clinical Cancer Research
                Original Research
                Custom metadata
                2.0
                January 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.6 mode:remove_FC converted:24.01.2021

                Oncology & Radiotherapy
                metastasis,prognosis,renal cancer,seer
                Oncology & Radiotherapy
                metastasis, prognosis, renal cancer, seer

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